Doctors in Germany have been allowed to prescribe medicines containing cannabinoids for five years now. Nevertheless, the prescription of medicinal cannabis continues to meet with skepticism – from patients and experts alike. Why is that the case? A look at history provides some explanations.
China: Cannabis as medicine mentioned for the first time
Today, medicinal cannabis is believed to have its roots in China. During excavations of the Yanghai tombs in western China, remains of seedlings, leaves and fruits of Cannabis sativa – the hemp plant – were found. Using archaeological methods, experts estimated their age at around 2,500 years.
Nowadays the pharmaceutical physician, pharmacist and botanist Li Shih-Chen (1518 -1593) is considered the father of Traditional Chinese Medicine and named more than 120 different uses of hemp. The most important applications were:
- Nervous upsets
- Menstrual pains
- Birthing difficulties
- Cramps
- Skin rashes, ulcers and wounds,
Further, Li Shih-Chen emphasized the antiemetic – that is, preventing nausea – effects of cannabis.
India: Cannabis as a sacred plant
In the ancient Vedas (1,500 – 1,300 BC), the hemp plant was described as sacred. In the religious writings, scholars describe, for example, ritual acts that were supposed to protect against enemies or appease evil forces. In addition, hemp was an integral part of magical, social and religious customs – it was believed to have a supportive effect in meditation and in dissolving anxiety and stress. Cannabis was also widely used as a medicine, among others for:
- leprosy
- diarrhea and fever
- painkillers and cough suppressants
- sedatives, sleeping pills and anesthetics
Cannabis was and is also used in tantric rituals in India, e.g. to promote sexual ecstasy. Generally, a distinction is made between three different preparations of hemp:
- Charras: resin produced by friction
- Bhang: traditional preparation for Hindu religious rituals. The leaves and flowers of the hemp plant are mixed with tobacco and processed with honey and spices into confectionery or dissolved in butter. Sometimes bhang lassi, a yogurt drink, is also offered
- Ganja: Marijuana
Ancient Greece and Rome: Cannabis also in veterinary medicine
Researchers assume that cannabis was hardly consumed in early antiquity. Thus, in the records of Hippocrates (around 460 BC) there is no reference to the use of the hemp plant.
Galen (Galenos of Pergamon, probably 129 – 199) mentions in one of his writings the appetizing effect of cannabis as well as its effect on pain conditions. Interestingly, horses were also treated with hemp extracts during this period.
Roman Empire: Cannabis finds mention in Materia Medica
Researchers assume that cannabis was hardly consumed in early antiquity. Thus, in the records of Hippocrates (around 460 BC) there is no reference to the use of the hemp plant.
Galen (Galenos of Pergamon, probably 129 – 199) mentions in one of his writings the appetizing effect of cannabis as well as its effect on pain conditions. Interestingly, horses were also treated with hemp extracts during this period.
Europe in the Middle Ages: Cannabis in Monastic Medicine
In the Middle Ages, monks and nuns had interpretive authority over all aspects of medical science. Since hardly any research was done, this period is often described as reactionary.
First references to the use of cannabis can be found in the writings of Hildegard von Bingens (1,098 – 1,179). The Benedictine nun and herbal expert mentions hemp for the treatment of various diseases, such as:
- ulcers and wounds
- rheumatic and bronchial diseases
- stomach problems with nausea
In addition, cannabis was used as a substitute for opium in the Middle Ages.
Europe in renaissance: cannabis experiences upswing
From the 16th century onwards, many entries can be found in various “herbal books”. Various physicians and botanists, such as Leonhart Fuchs and John Parkinson (England), mention cannabis in their writings and recommend its use for, among other things:
- dry cough
- jaundice
- diarrhea
- colic
- gout
- tumors, burns or pain
Furthermore, explorers and world travelers reported cannabis and brought back dried plants from India and the Middle East.
19th century: Cannabis as a panacea
The 19th century is considered the heyday of medicinal cannabis. In both Europe and the USA, it was one of the most widely sold medicines in pharmacies: Between 1850 and 1950, cannabis became a lighter and more digestible alternative to opium. Its uses were extremely wide-ranging:
- headaches and migraines
- neuralgia
- rheumatism
- epilepsie-like conditions
- sedatives and sleep enhancers
- bronchial asthma
In the 19th century, moreover, hemp smoking enjoyed increasing popularity. It was called “herb,” “oriental” or “knaster” and for a time represented a cheaper alternative to tobacco. When the latter became cheaper, the consumption of cannabis remained reserved for the upper classes. The side effects of the substance were also well known, with the slogan “Don’t mix Orient with beer, or your dreams will get muddled” heading some of the cans containing the popular herb.
Cannabis in times of war
Cannabis to enhance performance: Napoleon’s groups of soldiers used the relaxing effect of the hemp plant to cope with their major battles. The drug was also used in Germany – for example, in the Franco-Prussian War (1870-1871). The armies were able to increase both their fighting spirit and their willingness to perform, and in the aftermath they were better able to cope with the terrible events.
Cannabis in the beginning of the 20th century
The mood began to tip: The spread of cannabis led to the start of Prohibition in the United States of America. The basis for the incipient smear campaign was the fact that representatives of some sectors of the economy felt threatened by the wide applicability of hemp in the manufacturing industry – including paper production and the textile industry. Lobbyists spread rumors and called for a boycott of the raw material competitor.
Cannabis after U.S. prohibition: hate campaign picks up steam
In 1933, the alcohol prohibition introduced in 1920 was lifted by President Roosevelt. With the help of the Federal Bureau of Narcotics and under the direction of its chief Harry Anslinger, the U.S. government threw itself into combating the consumption of hemp. Thousands of Americans were sentenced to fines and imprisonment, and cannabis became a symbol of a US society divided by racism. Anslinger’s propaganda becomes clear in the following quote, which sounds unbearable to us today:
“There are 100,000 total marijuana smokers in the US, and most are Negroes, Hispanics, Filipinos and entertainers. Their Satanic music, jazz and swing, result from marijuana usage. This marijuana causes white women to seek sexual relations with Negroes, entertainers and any others.”
Anslinger’s campaign was not only tolerated but encouraged by the state. The government saw it as another way to control population groups that were considered incendiary.
Many of the reservations and stigmas associated with cannabis that still circulate in the western world today can be traced back to the propaganda of the “figurehead” Anslinger.
Cannabis in the 1940s: Therapy of withdrawal symptoms in opiate addiction
Under the leadership of the U.S. psychiatrist Samuel Allentuck, THC was used for the first time to treat withdrawal symptoms associated with opiate addiction – with good success. The same decade also saw the production of the first synthetic cannabinoids and their testing in clinical trials, such as the THC derivative pyrahexyl (Synhexyl). However, the exact chemical structure of THC was not yet known at that time.
1964: Israeli researchers identify the chemical structure of THC (delta-9-tetrahydrocannabinol).
They are considered pioneers of cannabis research: In 1964, the Israeli scientists Yechiel Gaoni and Raphael Mechoulam discovered the exact chemical structure of THC. The interest of pharmaceutical research was ignited and from then on was mainly focused on the metabolism and the harmful and beneficial effects of cannabinoids.
Early 1990s: discovery of the body’s endocannabinoid system
The discovery of the endogenous endocannabinoid system (ECS), with its endogenous cannabinoids (“endocannabinoids”) and their binding sites (“cannabinoid receptors”), by researchers at the U.S. National Institute of Mental Health reignited professional engagement.
The scientific knowledge about the interaction of herbal active ingredients and the human ECS still forms the basis for the medical use of the medicinal plant cannabis today.
Breakthrough for chronically and seriously ill people: Medical cannabis on prescription since 2017
Since March 2017, doctors have been allowed to prescribe medical cannabis and vaporizers for inhalation to certain patient groups. The health insurance company covers the costs of the treatment if an application for reimbursement is submitted and approved by the payer.
There is good evidence for adjunctive treatment with pharmaceutical cannabis in the following clinical patterns:
- chronic and neuropathic pain
- nausea and vomiting in chemotherapy
- loss of appetite and weight loss in HIV or tumor diseases
- parkinson’s disease
- tourette’s syndrome
- multiple sclerosis
- chronic inflammatory bowel disease
- sleep disorders
- depression
Sources:
Grotenhermen, Franjo: Die Geschichte der medizinischen Verwendung von Cannabisprodukten. Arbeitsgemeinschaft Cannabis als Medizin e.V.., 2018. Zugriff von: (arbeitsgemeinschaft-cannabis-medizin.de), (01.03.2022)
Geschichte von Cannabis als Rauschmittel (Leseprobe). MWV Berlin, 2018. Zugriff von: Microsoft Word – Raab_Cannabis_LK_161024_zum Druck (mwv-berlin.de), (01.03.2022)
Gregor Delvaux de Fenffe: Harry Anslinger. Planet Wissen, 08.05.2020. Zugriff von: Hanf: Harry Anslinger – Pflanzen – Natur – Planet Wissen (planet-wissen.de), (01.03.2022)
Die Geschichte der Hanfpflanze. Zugriff von: Die Geschichte Der Hanfpflanze Als Nahrung, Kleidung, Rauschmittel (hanfseite.de), (02.03.2022)